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Overview of Public Health Surveillance Denise Koo, MD, MPH Epidemiology Program Office Centers for Disease Control and Prevention.

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Presentation on theme: "Overview of Public Health Surveillance Denise Koo, MD, MPH Epidemiology Program Office Centers for Disease Control and Prevention."— Presentation transcript:

1 Overview of Public Health Surveillance Denise Koo, MD, MPH Epidemiology Program Office Centers for Disease Control and Prevention

2 Public Health Approach ProblemResponse Surveillance: What is the problem? Risk Factor Identification: What is the cause? Intervention Evaluation: What works? Implementation: How do you do it?

3 Public Health Surveillance Ongoing, systematic collection, analysis, and interpretation of health-related data essential to the planning, implementation, and evaluation of public health practice, closely integrated with the timely dissemination of these data to those responsible for prevention and control.

4 Public Health Surveillance Systematic, ongoing Collection Analysis Interpretation Dissemination Link to public health practice

5 Purposes of Public Health Surveillance Assess public health status Define public health priorities Evaluate programs Stimulate research

6 Core Public Health Functions Assessment Policy development Assurance

7 Surveillance Information for Action

8 Uses of Public Health Surveillance Estimate magnitude of the problem Determine geographic distribution of illness Portray the natural history of a disease Detect epidemics/define a problem Generate hypotheses, stimulate research Evaluate control measures Monitor changes in infectious agents Detect changes in health practices Facilitate planning

9 Uses of Public Health Surveillance Estimate magnitude of the problem Determine geographic distribution of illness Portray the natural history of a disease Detect epidemics/define a problem Generate hypotheses, stimulate research Evaluate control measures Monitor changes in infectious agents Detect changes in health practices Facilitate planning

10 Shigellosis United States, 1968-1998 0 0 5 5 10 15 Year 1968 1973 1978 1983 1988 1993 1998 Reported Cases per 100,000 Population Source: CDC. Summary of notifiable diseases. 1998.

11 Uses of Public Health Surveillance Estimate magnitude of the problem Determine geographic distribution of illness Portray the natural history of a disease Detect epidemics/define a problem Generate hypotheses, stimulate research Evaluate control measures Monitor changes in infectious agents Detect changes in health practices Facilitate planning

12 Rate of Hepatitis A United States, 1998 < 5.0 5.0–9.9 10.0–19.9 >20.0 NA NYC DC PR VI GUAM AM SAMOA CNMI Source: CDC. Summary of notifiable diseases. 1998.

13 Uses of Public Health Surveillance Estimate magnitude of the problem Determine geographic distribution of illness Portray the natural history of a disease Detect epidemics/define a problem Generate hypotheses, stimulate research Evaluate control measures Monitor changes in infectious agents Detect changes in health practices Facilitate planning

14 TOXIC SHOCK SYNDROME (TSS) United States, 1983-1998 TOXIC SHOCK SYNDROME (TSS) United States, 1983-1998 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 National Center for Infectious Diseases (NCID) data* National Electronic Telecommunications System for Surveillance (NETSS) data 0 20 40 60 80 100 120 140 160 Year (Quarter) Reported Cases

15 Uses of Public Health Surveillance Estimate magnitude of the problem Determine geographic distribution of illness Portray the natural history of a disease Detect epidemics/define a problem Generate hypotheses, stimulate research Evaluate control measures Monitor changes in infectious agents Detect changes in health practices Facilitate planning

16 Botulism (Foodborne) United States, 1978-1998 Outbreak caused by potato salad, NM Outbreak caused by sautéed onions, IL Outbreak caused by fermented fish/sea products, AK Outbreak caused by baked potatoes, TX Laboratory- confirmed cases* NETSS data 0 0 10 20 30 40 50 60 70 80 90 100 110 Year 1978 1983 1988 1993 1998 Reported Cases Source: CDC. Summary of notifiable diseases. 1998.

17 Uses of Public Health Surveillance Estimate magnitude of the problem Determine geographic distribution of illness Portray the natural history of a disease Detect epidemics/define a problem Generate hypotheses, stimulate research Evaluate control measures Monitor changes in infectious agents Detect changes in health practices Facilitate planning

18 Year Reported Cases (Thousands) Vaccine licensed 0 0 50 100 150 200 250 300 350 400 450 500 1963 1968 1973 1978 1983 1988 1993 1998 MEASLES — by year, United States, 1983–1998 0 0 5 5 10 15 20 25 30 Year 1983 1988 1993 1998 Reported Cases (Thousands) MEASLES (Rubeola) United States, 1963-1998 20 10

19 Pertussis (Whooping Cough) United States, 1998 0 0 300 600 900 1,200 1,500 1,800 2,100 2,400 Age Group (Years) <1 1–4 5–9 10–14 15–19 20–29 30–39 40–49 50–59 >60 Reported Cases

20 Uses of Public Health Surveillance Estimate magnitude of the problem Determine geographic distribution of illness Portray the natural history of a disease Detect epidemics/define a problem Generate hypotheses, stimulate research Evaluate control measures Monitor changes in infectious agents Detect changes in health practices Facilitate planning

21 Poliomyelitis (Paralytic) Year 0 0 5 5 10 15 20 25 30 35 40 45 50 55 60 1968 1973 1978 1983 1988 1993 1998 Reported Cases Source: CDC. Summary of notifiable diseases. 1998. Rate/100,000 Population Year Inactivated Vaccine Oral Vaccine United States, 1968-1998

22 Uses of Public Health Surveillance Estimate magnitude of the problem Determine geographic distribution of illness Portray the natural history of a disease Detect epidemics/define a problem Generate hypotheses, stimulate research Evaluate control measures Monitor changes in infectious agents Detect changes in health practices Facilitate planning

23 Trends in Plasmid-Mediated Resistance to Penicillin and Tetracycline United States, 1988-1997 Source: Gonococcal Isolate Surveillance Project (GISP) Percent 0 2 4 6 8 10 12 1988198919901991199219931994199519961997 PPNG TRNG PPNG & TRNG Year

24 Uses of Public Health Surveillance Estimate magnitude of the problem Determine geographic distribution of illness Portray the natural history of a disease Detect epidemics/define a problem Generate hypotheses, stimulate research Evaluate control measures Monitor changes in infectious agents Detect changes in health practices Facilitate planning

25 Breast Cancer Screening

26 Uses of Public Health Surveillance Estimate magnitude of the problem Determine geographic distribution of illness Portray the natural history of a disease Detect epidemics/define a problem Generate hypotheses, stimulate research Evaluate control measures Monitor changes in infectious agents Detect changes in health practices Facilitate planning

27 Foreign- born Tuberculosis United States, 1986-1998 (U.S.- and foreign-born persons)

28 Obesity United States, 1987-1998 Not available < 10 % …… ……. 10%-15% >15%

29 Source: BRFSS 1998 Physical Activity Georgia 1998 Less than 15,000$ 15,000- 24,999$ Responses 25,000- 34,999$ 35,000- 49,999$ $50,000> NO YES PER CENT

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